# A Digital Health Solution for Improving Parent Adherence and Sustainability of ADHD Treatment Outcomes

> **NIH NIH R34** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $726,750

## Abstract

ABSTRACT
 Behavioral parent training (BPT) is well-established for treating Attention Deficit Hyperactivity Disorder and
associated impairments, but short-term treatment gains for children typically lack generalizability and
sustainability. Lack of parental adherence contributes to these limited effects, since BPT relies on parents
using treatment-recommended parenting skills with children in daily life contexts. A number of barriers can
impede parent adherence including skill competence, executive functioning (EF) processes, and motivation/
attitudes, as well as maintenance-specific barriers after in-person treatment ends (e.g. competence adapting
skills to new challenges; EF/motivational barriers from lack of ongoing social support). Such barriers may be
directly addressable through innovative dHealth tools. The objective of this study is to develop and test a novel
and scalable digital health solution designed to address barriers and improve parent skill utilization in daily life
contexts, the hypothesized mechanism of action for BPT, with the goal of improving sustainability of treatment
outcomes for youth with ADHD. A dHealth tool will be fully developed to augment group-based BPT in school
settings, maximizing accessibility of the treatment. Aim 1 is to develop a technology-enhanced version of
behavioral parent training for improving parent adherence and collect preliminary data on usability, feasibility
and acceptability. Qualitative and quantitative input from key stakeholders (parents, children and clinicians)
through focus groups, qualitative interviews and extended formative usage testing will be obtained. The tool
addresses barriers to skill utilization with specific features: 1) skill competence: skills library/videos, knowledge
questions, tailored content, and interactive troubleshooting wizard, 2) EF processes: in vivo notifications for
skill use/coaching, linked parent/child views of interactive/personalized plans integrated in daily routines with
child involvement, streamlined content, 3) motivation/attitudes: motivational/ ”change talk” messaging, goal-
setting, automated monitoring of parent/child progress, gamification, and digital rewards, 4) maintenance-
specific barriers: individualized troubleshooting to assist with new problems and social features to support
parents after in-person treatment ends. Aim 2 is to implement a pilot RCT of the technology-enhanced version
of BPT (N=30) compared to BPT only (N=30) to gather preliminary efficacy data on immediate and sustained
(up to 12 months after treatment) parent skill utilization (primary target), and parenting barriers (intermediate
targets) to inform a larger scale trial. Aim 3 is to examine whether parent skill utilization (target mechanism) is
engaged by the app and whether this engagement is associated with improved child outcomes. We will explore
the association between: (a) app use and skill utilization; (b) skill utilization and child outcomes, and c) app use
with red...

## Key facts

- **NIH application ID:** 10056759
- **Project number:** 1R34MH122222-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Linda Pfiffner
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $726,750
- **Award type:** 1
- **Project period:** 2020-07-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10056759

## Citation

> US National Institutes of Health, RePORTER application 10056759, A Digital Health Solution for Improving Parent Adherence and Sustainability of ADHD Treatment Outcomes (1R34MH122222-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10056759. Licensed CC0.

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